Mild, Moderate and Severe
Aesthetic dermatologist S. Manjula Jegasothy, M.D., founder of Miami Skin Institute, Miami, Fla., says wrinkle classification systems lack specificity.
“There can be someone who, let’s say is in her mid-20s, who comes to me with a moderate-to-severe glabellar wrinkle that would be mild in someone who is 50,” she says. If a micrometer or some sort of measurement were put to it, those patients might have the same depth but would be considered very differently in different age groups,” Dr. Jegasothy says. “Wrinkle severity scores are pretty much used to standardize results for studies. In practice, I think most of us are mild, moderate and severe.”
Mild, moderate and severe is precisely how Joe Niamtu, III, D.M.D., an oral and maxillofacial surgeon with a practice limited to cosmetic facial surgery in Richmond, Va., does wrinkle assessments.
“There are two types of people. There are the dogmatic people who embrace numeric quantification and try and apply that to clinical practice. And there are those that are more clinically oriented and pay less attention to dogma in quantification,” Dr. Niamtu says. “My favorite classification system is mild, moderate and severe.”
It is, however, important to have a standardized classification system in some situations outside of research, according to Dr. Niamtu. Those include when communicating with other doctors for a higher degree of accuracy, and for medical records, medical-legal situations or insurance coding, where applicable.
Three Wrinkle classification systems at a glance:
The Modified Fitzpatrick Wrinkle Scale is a clinically reliable validated tool for nasolabial wrinkle severity assessment, according to this study. https://www.ncbi.nlm.nih.gov/pubmed/18547187
The Glogau Wrinkle Scale (http://sfderm.com/glogau-wrinkle-scale/) was developed by dermatologist Richard Glogau, MD.
Merz Aesthetics Scales measure the upper face, mid-face, lower face and neck, platysmal and hands, according to the company website https://www.merzaesthetics.com/products/scales//